T – Public Health

A. Public health refers to prevention of threats to the population – only direct, coercive governmental interventions are topical. It excludes private organizations or clinics

Rothstein, 02 (Mark, Chair in Health Law and Policy, at Bradeis University School of Law and School of Medicine, Journal of Law, Medicine, and Ethics, Summer, “Rethinking the Meaning of Public Health”, ebsco)

Government intervention as public health. The third conception of public health, and the one I advocate, is more limited in scope. "Government intervention as public health" involves public officials taking appropriate measures pursuant to specific legal authority, after balancing private rights and public interests, to protect the health of the public. These measures may be coercive. The existence of a public threat demands a public response, and in a representative political system it is the government that is authorized to act on behalf of the public.' -^ The police power is the constitutional authority on which public health mea- sures are based. According to the U.S. Supreme Court: According to settled principles, the police power of a state must be held to embrace, at least, such reasonable regulations established directly by leg- islative enactment as will protect the public health and the public safety.... There are manifold restraints to which every person is necessarily subject for the common good. On any other basis organized society could not exist with safety to its members." The moral and political authority (and duty) of the government to mandate public health actions, including quarantine, isolation, immunization, contact tracing, property seizures, and environmental regulation, derives from one of the following three conditions. First, the health of the population is threatened. The paradigmatic public health threat is an infectious disease, where the threat to the public is through the horizontal transmission of infection. Other health threats may have a public health effect because they involve common resources and because the failure to control the problem at the source will lead to adverse health consequences to many people. Thus, person-to-person trans- mission is not necessary to have a public health threat. Food safety, sanitation, water fluoridation, insect and vermin control, and pollution control are examples of public health measures to address health threats to the public. The second type of condition to justify a public health intervention occurs when the government has unique pow-ers and expertise related to an essential aspect of public health. Disease reporting and surveillance illustrates this category. Legally mandated reporting of certain types of health conditions, such as some infectious diseases, occupational diseases, cancers, sexually transmitted diseases, gunshot wounds, child fatalities, and suspected cases of domestic violence, are all important to the collective health of the community. Reporting allows for data aggregation and analysis as well as more direct intervention to prevent additional cases. Without mandatory reporting, important cases would be lost, and only the government has the authority to mandate reporting. Moreover, government public health agencies have access to the trained professionals needed to interpret the data. The third type of condition to justify a public health intervention occurs when government action is more efficient or more likely to produce an effective intervention. An example would be newborn screening programs, which are mandated by law in every state. Public health programs to identify
T – Public Health

inborn errors of metabolism and other heritable disorders offer uniformity in standards and reporting. In addition, screening programs are often tied to publicly financed follow-up and treatment. The key element of public health is the role of the government — its power and obligation to invoke mandatory or coercive measures to eliminate a threat to the public's health. Without a threat to the public, it is much more difficult to make a case for the use of coercive powers; in the absence of such legal authority, the participation of individuals in health- enhancing activities ordinarily must be voluntary. Applying these principles to the three sources of moral and political authority for governmental public health activity, the justification for activity goes in descending order from (1) population-wide health threat; to (2) unique governmental powers and expertise about an essential aspect of public health; to (3) the need for more efficient and effective governmental action in ensuring public health. Public health activities in this third category may overlap with population health measures. Consequently, newborn screening for phenylketonuria (PKU), congenital hypothyroidism, and other disorders; school-based medical screening for scoliosis, tuberculosis, vision and hearing problems, dental caries, and other conditions; and broad health promotion activities may be considered in varying degrees by different jurisdictions to lack the urgency and public health effects necessary to require universal participation. Under this narrower definition of public health, a "public health clinic" providing primary care is not engaged in public health; it is a public entity providing individual health care. In the United States, because there is no guaranteed access to health care, the responsibility for providing health care to uninsured individuals often falls to public health agen- cies. One effect of this allocation of responsibility is that providing primary care services tends to be commingled with, and to crowd out, other public health functions. As a result, many health departments lack the resources to engage in core public health functions, such as epidemiology, disease surveillance, and environmental regulation.

B. Violation—the affirmative provides assistance to nongovernmental organizations, not directly to African governments

C. This is a voting issue


1. Limits – there are potentially thousands of NGOs that an aff could fund; we can’t get specific disads to all of them and the topic is already too broad—it involves 48 countries and any kind of assistance that prevents death—stable plan mechanisms are the only way the affirmative can get predictable ground

2. Core negative ground is lost—we should be able to read disads to funding African governments—this is the core controversy in the literature and we can’t read African politics, corruption disads, shunning, or coercion disads—and the NGOs counterplan is a vital negative generic

3. Potential abuse is a voter – aff interp opens the floodgates and this research-burden limits what we could have ran.